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Remember the “death panels” hysteria in 2009 or so when the Affordable Care Act was under development? (PolitiFact called “death panels” the “lie of the year” for 2009, not surprising, since the idea apparently originated with that truth stretcher extraordinaire, former Alaska Gov. Sarah Palin.)

As you may have heard, that rhetoric resurfaced during town halls held by a few Republican members of Congress.

That idiocy came from language in the ACA that authorized Medicare to pay for voluntary end-of-life counseling. It was falsely projected as a “mandatory” activity every five years.

Some of the hysteria also stemmed from a specific clause in the ACA that said:

Establishes an Independent Payment Advisory Board to develop and submit detailed proposals to reduce the per capita rate of growth in Medicare spending to the President for Congress to consider. Establishes a consumer advisory council to advise the Board on the impact of payment policies under this title on consumers.

The fear, from the right-wing punditry was that bureaucrats would start to deny care to older, sicker Americans.

Other ACA provisions related to Medicare are not changed, including:
* Increase Medicare premiums (Parts B and D) for higher income beneficiaries (those with incomes above $85,000/individual and $170,000/couple).
* Authorize an Independent Payment Advisory Board to recommend ways to reduce Medicare spending if the rate of growth in Medicare spending exceeds a target growth rate.
* Establish various quality, payment and delivery system changes, including a new Center for Medicare and Medicaid Innovation to test, evaluate, and expand methods to control costs and promote quality of care; Medicare Shared Savings Accountable Care Organizations; and penalty programs for hospital readmissions and hospital-acquired conditions.

So, is the GOP plan embracing death panels, or is Republican leadership simply admitting that they were lying all along to whip up paranoia?

Here’s the easiest prediction I will make this week: Dr, Andrey Ostrovsky, chief medical officer of the Center for Medicaid and CHIP Services, is about to lose his job after just six months.

How do I know this? Ostrovsky isn’t just privately opposed to the American Health Care Act — the newly released Republican “repeal and replace” of the Affordable Care Act. He tweeted his opposition to the bill yesterday.

And he made the likely fatal mistake of citing outside opinions that don’t square with those of the Trump administration. Indeed, the American Medical Association, American Academy of Family Physicians and American Academy of Pediatrics have all come out against the first iteration of the AHCA.

We know that President Donald Trump pays attention to what gets said on Twitter. We also know what the Trump White House thinks of dissension within the ranks. Ask longtime U.S. Department of Justice attorney Sally Yates about that.

And she wasn’t just fired. The administration questioned her patriotism by saying Yates “betrayed the Department of Justice by refusing to enforce a legal order designed to protect the citizens of the United States.”

Expect Ostrovsky to lose his job soon, in no small part because his tweet has so many likes and retweets. Perhaps it was a calculated move on his part?

Free Healthcare IT Newsletter Want to receive the latest news on EMR, Meaningful Use,
ARRA and Healthcare IT sent straight to your email? Get all the latest Health IT updates from Neil Versel for FREE!

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